Fracture question

Patient in car accident, goes to out-of state hospital, fratured 3 toes. Patient put in Cam walker and comes to her local orthopedist for care. Ortho doc bills out toe fractures x 3. All claims deny as inclusive. If the hospital also billed the fracture charge, what recourse do we have, considering that we actually treated the fractures?

you do not bill out for the fracture, you can use the V54.x for the followup for healing fx, then if the hospital billed the fx care you can bill the fx care with a 55 modifier, if they did not bill fx care you can bill an office level.

Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.